400 



SURGICAL APPLIED ANATOMY, [chap. xix. 



could only separate the' articulating surfaces about 



one-fifth of an inch. 



3. The lordosis, or curving forwards of the 



spine, occurs in the dorso-lumbar region. It depends 



upon the flexion of the limb, and is the result 



of an attempt to con- 

 ceal that false posi- 

 tion, or at least to 

 minimise its incon- 

 veniences (Fig. 38). 

 When the thigh is 

 flexed at the hip by 

 disease, the lower 

 limb can be made to 

 appear straight by 

 simply bending the 

 spine forwards in the 

 dorso - lumbar region 

 without effecting the 

 least movement at the 

 disordered joint. In- 

 deed, the movement 

 proper to the hip is in 

 this case transferred 

 to the spine. A 



the dotted line) straight, and spine , , -,-1 n j 



normal. B, The flexion concealed or patient With a flexed 



SSpfSySJW^*' 1 *? 1 the hip as the result of 



disease can lie on his 



back in bed, with both limbs apparently perfectly 

 straight, he having concealed the flexion, as it were, by 

 producing a lordosis of the spine. If the lordosis be 

 corrected, and the spine be made straight again, then 

 the flexion of the hip reappears, although all the time 

 the hip joint has been absolutely rigid. This lordosis 

 generally appears a little late in the disease, and after 

 the limb has become more or less fixed in the false 

 .positions by contraction of the surrounding muscles. 



Fig. 38. Diagram to show the Mode of 

 Production of Lordosis in Hip Disease. 



A, Femur flexed at hip, pelvis (represented by 

 the dotted line) straight, and spine 



